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The Effect of Exogenous Glucocorticoids on Plasma Catecholamines and Metanephrines in Patients Without Phaeochromocytomas

Lookup NU author(s): Dr David Walker, Dr Stephen Ball

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Abstract

The aim of the study was to evaluate the effects of steroid administration under standardised conditions in a range of patients both normal and with adrenal pathologies and to review the impact on plasma catecholamines and meta nephrines. Corticosteroid administration has been linked to the development of hypertensive crises in patients with phaeochromocytoma, however a mechanism for this is not fully understood. We aimed to add useful information about the effect of steroids on levels of these hormones under usual circumstances. A prospective, observational cohort study of 50 patients undergoing the low-dose dexamethasone suppression test (LDDST) was undertaken. Additional blood samples were taken at the start and end of the standard LDDST. Biochemical analysis was carried out for plasma catecholamines and plasma free metanephrines. Demographic and hormonal data were acquired from review of the notes or measured at baseline. No significant changes in plasma catecholamines or metanephrines were seen at the end of the LDDST compared to baseline. This was also true of subgroup analysis, divided by age, gender, or type of underlying pathology. Our results suggest that hypertensive reaction responses, rare as they are, are unlikely to be related to normal adrenal physiology. Thus LDDST is likely to be safe under most circumstances, however caution should be exercised in patients with adrenal masses with imaging characteristics compatible with phaeochromocytoma. It may be prudent to defer glucocorticoid administration until functioning phaeochromocytoma has been excluded biochemically.

Publication metadata

Author(s): Ball S; Walker D; Druce MR; Maher KT; Dodzo K; Perry L; Peaston R; Chew SL; Drake WM; Akker SA; Grossman AB

Publication type: Article

Publication status: Published

Journal: Hormone and Metabolic Research

Year: 2011

Volume: 43

Issue: 4

Pages: 292-295

Print publication date: 01/04/2011

ISSN (print): 0018-5043

ISSN (electronic): 1439-4286

Publisher: Georg Thieme Verlag

URL: http://dx.doi.org/10.1055/s-0030-1270520

DOI: 10.1055/s-0030-1270520

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